First published on July 13, 2015 in observance of the COPH’s 30^th anniversary celebration.

Jodi Ray is a bundle of energy when she talks about the project that has become her life’s work, Florida Covering Kids and Families, which is a part of the Lawton and Rhea Chiles Center for Healthy Mothers and Babies.

The founding program director was Mary Figg, a state representative for Hillsborough County.  After a year or two of preliminary maneuvers, the initiative began formally in 1999.  Figg had enlisted Ray, who has a master’s degree in mass communications, the year before to be program coordinator and handle all things media, including assisting her with crafting the successful request for that all-important initial grant.

“My job was to manage a multimedia campaign.  I’ve done a lot of mass communications on this job,” she said.  “In fact, I’d say I do more of that than anything else.”

The project was funded its first seven years by the Robert Wood Johnson Foundation to do outreach enrollment of children eligible for the Children’s Health Insurance Program and Medicaid.  During that time, a staff of two more than doubled to five by 2006, then, when that funding ended, was cut all too literally in half, reduced to a project director, a coordinator and a half-time assistant: essentially, a staff of 2-1/2.  Fortunately, they had a dedicated network behind them.

Jodi Ray

“We have a state coalition,” Ray said, “a large collaboration of partners from around the state and local coalitions in almost every community in the state.  We came together and said, ‘Our mission is to get uninsured into coverage.’”

The coalition was initially mandated by the RWJF grant, Ray said.  It remains active today and includes some of its original members.  No question, it answered a critical need in 2006, when half the staff was asked to keep up with an exponential work-load increase created three years earlier.

Crying on the phone

“In 2003,” she explained, “the state ended all outreach efforts for CHIP.  So they literally boxed everything up and sent it to me.  They gave me their contact lists and all of their partnerships and said, ‘Could you please take this on?’  Now granted, there were no financial resources with that at the time.”

“The state also closed enrollment for CHIP in Florida for 18 months.  As a result of that, we lost over 300,000 kids in the Florida KidCare program.  In one month alone, we lost 40,000 kids.

“There was no statewide outreach initiative except us,” she said, “me and my other 1-1/2 people.  The number of calls I got was unbelievable.  People were calling and crying.  It was terrible.”

That situation started Ray on an 18-month crusade, talking to newspaper editorial boards, legislators, community leaders, almost anyone who would listen.

Committed to moving forward, she and the coalition began implementing a plan that was as innovative as it was aggressive:  Sign up as many kids as possible to a waiting list.  When the list reached 120,000, the New York Times took notice and gave the state a boatload of blistering press.  Not long after, the governor issued an executive order to enroll all the kids on the list, and open enrollment returned permanently four months later.

In 2007, a new governor, Charlie Crist, declared the uninsured rate among children appalling.  He brought the state agencies together, Ray said, and told them to figure out how to make it better, and fast.

“One of the things they did was decide to give us some resources,” Ray said.

A state contract and marketing materials soon followed, along with help from state agency staffs on routine but time-consuming matters like mailing.  Growth was back, and with it, ramped-up after-school activities and more engagement with local businesses.

The results since have ranged from impressive to remarkable.  Since the first open enrollment period began on Oct. 1, 2013, the project has gained national media coverage for enrolling about 2.5 million previously uninsured Floridians, twice the expectation.

“We expanded to focus on all the newly eligible uninsured to help them get into whatever coverage options are available,” Ray said, “whether under the Affordable Care Act in the marketplace or Medicaid or CHIP.  One way or another, we were going to help people who didn’t have coverage get health insurance so they could get access to health care services.

“Health care services are important, and having preventive care, all those things.  We talk about all those things being necessary, but you’re not getting in the door unless you have health insurance.  So that’s what we focus on: the first step, getting people in the door.”

That may be the focus, but there’s plenty more to do.

“We also do one-on-one application,” she said.  “We have consumers that actually sit down with us and do enrollment.  We do everything that involves connecting people to health coverage.

“We even do some health literacy.  How do you use health insurance?  How do you make an appointment to see a doctor?  For many of the uninsured, these are not obvious.”

“We work with all the agencies on both the state and federal levels that are involved in implementing health coverage, and we get out there and shake the bushes.”

Media and more

As much effort as is spent on finding the uninsured, many do find FCKF first, Ray said.

“We get cold calls for everything,” she said.  “I used to wonder sometimes how people find us, but I don’t wonder that anymore.  All you have to do is help somebody.  Then that person gives your number to somebody else.  We get a lot of calls by word of mouth.  We helped someone at some point, and even years later, we get a call from that person’s family member or friend who needs help.”

“The things that consumers come in here and tell you are unbelievable, sometimes heartbreaking.  That’s the other thing that’s really tough,” she said.  “I’ve gotten calls that have made me literally get up and walk around the building a few times because the stories are terrible: the family living in a car; the kid who’s got some kind of horrible heart condition; the mother who had CHIP coverage, but something went wrong with her renewal, it got dropped, it’s Christmastime and she has no money because the asthma medication she had to pick up for her son cost $400.”

While grants provide the funding, the University of South Florida and College of Public Health make it work, Ray said.

“Our work has been very well supported by both the College of Public Health and the University.  I say this out loud every day:  I don’t think anybody doing this work could be in a better place.  I don’t think there’s any way Dr. Petersen could support our work any more than she does.  We get so much support from one end of this university to the other, and we worked with everybody through open enrollment.”

Student Health Services, the libraries, the Morsani College of Medicine and the Marshall Center were regular haunts, as were the St. Petersburg and Sarasota-Manatee campuses.

From the beginning, Ray, who became director upon Figg’s retirement in 2003, has been the media go-to person from the beginning, and that responsibility has grown as exponentially as the project itself.

“We do four press conferences a year.  I spend a ridiculous amount of time talking to reporters.  Just in the first open enrollment period alone, I probably did 80 or 90 interviews with reporters from one end of the country to the other.”

The result was major articles in The New Yorker, the New York Times and the Los Angeles Times, to name a few, as well as pieces widely disseminated by the Associated Press and Reuters, as well as personal visits from two national health secretaries.

Ray on Capitol Hill in a nationally televised discussion.

“During the first open enrollment period, we had the second-largest grant in the country,” Ray said.  “That, in itself, drew attention, and [U.S. Health and Human Services Secretary Kathleen Sebelius] came here, herself, and awarded the grant.  She came to the college, and that’s how I found out we’d gotten the grant.”

It’s little wonder, then, that what began with two people 17 years ago keeps a dozen in the USF office busy with training, policy work, education, outreach, grant-writing, communications, etc.  It’s an office full of multi-taskers, Ray said.

“We all do all of it,” she said.

Given the complexities of health insurance laws and regulations, not to mention a new set of rules for navigators, just keeping up is a task unto itself.

“We do have to make it a point to stay informed.  We’re constantly on webinars and trainings, reading policies and reading new rules.  We have our hands in a lot of different elements of public health, just because we have to.”

The toughest part of the job, she said, is not being able to help everyone.

“We still have a gap of folks who are not going to qualify for coverage they can afford because the state has not expanded Medicaid coverage,” she said.  “I’d like to see us be able to enroll everyone who has no access to health coverage.  I’d like to see that in less than five years, quite frankly.  I would hate for that to be a five-year goal.”

Ray makes it obvious that what she and her colleagues do at Florida Covering Kids and Families is what keeps her pumped with energy.

“It’s all very exciting,” she said.  “We’re right there at the front end of this, and that, in and of itself, is exhilarating.  I feel good about what we’ve been able to accomplish, so it’s all been worth the time and effort – and the stress and the exhaustion – because it’s paid off.  We’re actually having an impact, and people see it.”

Every flight needs a navigator

The federal navigator initiative aimed at getting people into the new health insurance marketplace has been a major focus of their work the past two years, as well as a major hallmark of their success.

“The navigators are tied specifically to the federal marketplace.” Ray explained, “Some states are not participating in the federal marketplace, but Florida happens to be one of those states that is.”

The federal program provides outreach enrollment funds.  The first funding opportunities began in 2013, Ray said, and her office applied for USF to get an award that would cover the state.  She and her team did all the grant writing.

“We had already been doing this work on the ground across the state to enroll kids in CHIP and Medicaid,” Ray said, “and many of the partners around the state had come to a consensus that it made perfect sense for us to be the applicant for this grant and take the lead.  So, what we did was look at the model that was already working and find a way to expand on that.”

The result was a $4.2-million award in 2013 to cover 64 of the state’s 67 counties, the exceptions being Broward, Miami-Dade and Monroe, which submitted their own applications separately.

“The second year,” Ray said, “we went back to those partners again and asked them if they would like to join us for the 2014 application.  They said yes the second time around, so the second time around, we covered all 67 counties in Florida.”

The second award was worth $5.3-million.  Ray’s group had secured million-dollar grants for their Children’s Health Insurance Program enrollments, but those, which  had been their largest to date, are easily dwarfed by the Navigator grants.

Most of the funds are vested in the people who get the job done, Ray said.

“A lot of people.  I’m a big believer that priority number one should be the human resource.  The folks on the ground.  The folks who are out there doing the education, the communication, the one-on-one application assistants, the people who know the processes.  We know from our history of doing this and tons of research that these are the folks who keep people from getting lost along the way through the process.”

In one regard, Ray said, the Navigator’s work has only begun with the enrollment stage.

“They help people navigate the enrollment process and get to the point where they can be enrolled and covered, and they’re also key to helping people appropriately use health insurance,” she said.  “We want folks not just to get in, but we want them to keep their coverage and to use their coverage properly.

“When you’re connecting people to health care coverage for the first time, these are not innately understood concepts.  Insurance is actually a pretty complicated idea, and if you’ve never used it, you really can get overwhelmed.  If you have it and you’re not using it, then the tendency to understand its value can be diminished.  The Navigators and the Florida KidCare application assisters on the ground are essential for that piece of it.  It’s not just about filling out the forms.”

The numbers tell just how busy those people on the ground have been.

“The first year, the projected enrollment for the federal health insurance marketplaces in Florida was around 450,000, give or take,” Ray said.  “We ended up enrolling – with all partners across the state, not just the USF partners – almost a million.  We doubled the projections, basically.

“The second year, the last number I saw was about 1.6 million, but that didn’t include the last month, the limited special enrollment period for people who got hit with the tax penalties.”

As impressive as those figures are, their national rank may be more so, especially given California’s stand as by far the most populous state of the union.

“The first year, every month, we came in second in the country to California,” Ray said.  “This year, our enrollment here in Florida was higher than enrollment in any other state in the country.  It’s a pretty successful initiative in Florida.”

That seems understated, especially considering that it was the work of about 90 Navigators the first enrollment period and around 150 the second round.  Ray was quick to note, however, that Navigators weren’t the only people involved.

“There are more resources that go into managing this than just the enrollment folks,” she said.  “We have IT people involved, we have human resource people involved, we have grant administrators involved.  It’s an undertaking, for sure.  It’s all a team effort.”

A niche in the state’s public health

The stakes, along with the numbers, will be higher for the third round, since the funding will be for three years.  Ray is undaunted by the change and, in fact, favors it.  For one thing, it will provide greater continuity in enrollment services, she said.

“We won’t have the start-up delays that come with a grant ending,” she explained, “and then waiting for another grant to come in.”

Given the early success but also knowing the nature of the funding world, Ray is cautiously optimistic about future Navigator grants.

“We’re keeping our fingers crossed,” she said.  “I feel like we’ve done a good job.  I think our outcomes have been really high.  Our partners at the federal level seem very pleased with the work that we’re doing.

“Florida certainly has been a shining star all the way through this.  Not because I was optimistic, but because I believed we were doing the right thing and that we knew what we were doing, I’m not surprised.  Because we didn’t go into this making up a plan of action.  We went into it with a sense of how it can be done, what the best practices were.  We had learned our lessons along the way.  We didn’t have to reinvent the wheel to do this.  All our collaborative partners made a big difference, too.

“I feel pretty good going into years three through five.  It’s going to be harder going into these years, because we’ve enrolled so many of the low-hanging fruit, so we really have to hone in on who we’re missing and whatever we need to do to make sure we’re not leaving people behind.

“This is our niche for the state of Florida in public health.  Whether it’s obesity or diabetes or getting cancer screenings, it’s very difficult for people to do anything about those things we talk about in public health if they don’t have health insurance.  So, I think we’re doing something valuable in contributing that first step to addressing some of these important public health issues that are so important.”

Story by David Brothers, College of Public Health.  Graphics courtesy of Florida Covering Kids and Families, CSPAN and Jodi Ray.

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The Federal Open Enrollment Period (OEP) to sign up for or change health insurance plans runs from Nov. 1, 2023, through Jan. 15, 2024. Navigators from Florida Covering Kids & Families (FL-CKF), housed within the USF College of Public Health, along with their community partners are poised to help consumers find health insurance plans that are right for them.

Florida Covering Kids & Families works collaboratively with Florida agencies and stakeholders to advocate and conduct outreach to ensure all Floridians have access to affordable healthcare coverage. It has seven contracted partners that serve all 67 counties in Florida and is funded by a multimillion-dollar, multi-year grant from the U.S. Health and Human Service Centers for Medicare and Medicaid Services.

While the FL-CKF has no large-scale, in-person sign-up events scheduled in the community this year, Nikia Gates, program manager for the FL-CKF Navigator Project, said Navigators—specially trained individuals who help a consumer “navigate” the health insurance marketplace—are just a phone call away to answer questions and schedule in-person or virtual appointments.

“Florida Covering Kids & Families will provide education and support, offer referrals when applicable, and schedule appointments with a Navigator partner in the consumer’s area if needed,” Gates said. “We will also be providing technical support to the Affordable Care Act consortium of partners. Additionally, we will be contacting consumers via mail through the Centers for Medicare & Medicaid Services Marketplace Assistance Community (MAC) database.”

Navigators will also be out and about in the community.

Family Healthcare Foundation, a Tampa-based nonprofit that partners with FL-CKF and provides outreach and application assistance in publicly funded health care programs such as Florida KidCare, the Health Insurance Marketplace and local county health care programs, will have Navigators meeting with consumers on the phone and virtually. Tampa Bay Navigators will be at locations such as Tampa General, BayCare Health Systems hospitals, the Children’s Board of Hillsborough County Family Resource Centers and Feeding Tampa Bay’s Empowerment Centers.  

“Offering multiple options to meet with a Navigator at a variety of community and clinical settings truly ‘meets’ people where they are to help them navigate a complicated system of understanding what their health insurance options are,” Katie Roders Turner, executive director of Family Healthcare Foundation, said. “We assist anyone and encourage everyone to reach out to speak with us if they are looking for health insurance information. Navigators are always free and always confidential.”

Anyone exploring new health insurance options or needing to change an existing plan is urged to utilize the OEP.

“The OEP is open to everyone. Appointments are available virtually, over the phone, and in person,” Gates said. “Anyone needing assistance getting health coverage through the Marketplace can call Covering Florida at (877) 813-9115 or visit coveringflorida.org to book an appointment with a Navigator in their area. Consumers can also visit healthcare.gov to explore resources that will help make enrollment faster and easier. Resources are available to help consumers determine if they qualify for savings, making health care even more affordable.”

Story by Donna Campisano, USF College of Public Health

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Sophany Nuth’s 30-hour-a-week job baking doughnuts doesn’t come with health insurance.

His weekly take-home pay is about $318. With rent, food and other bills, the 35-year-old Seffner fathercouldn’t afford the $400 a month quotes he got from private health insurers to cover him, his wife and two young children.

He was so worried, Nuth considered moving his family to Canada or Australia, which have universal health care.

“It’s a big stress in the family,” he said.

But Nuth is staying in Florida after enrolling his family in a health care plan through the Affordable Care Act marketplace that he found with the help of navigators from the Family Healthcare Foundation. It will cost just $18 a month.

He is one of a record 2.7 million Floridians who have signed up for health insurance through the Affordable Care Act for 2022, a 600,000 increase from last year.

The federal program, which was signed into law by President Barack Obama in 2010, is more popular than ever nationwide, too. A record 14.5 million people signed up for this year, surpassing the previous high by almost 2 million. That’s despite Republican attempts to challenge it in court and abolish it during President Donald Trump’s term.

That’s due to President Joe Biden’s administration, which spent more on marketing and increased investment in the availability of subsidies through last year’s $1.9 trillionAmerican Rescue Plan, said Jodi Ray, the executive director of Florida Covering Kids & Families.It’s a navigator program based at the University of South Florida in Tampa that coordinates outreach efforts across the state.

The Department of Health and Human Services restored $80 million to fund outreach efforts cut by the previous administration with the goal of quadrupling the number of navigators, who help people pick and enroll in insurance plans. Also, more insurance companies offered plans in the federal marketplace this year and the cost of premiums remained flat or, in some cases, dropped slightly.

Read the full story from Tampa Bay Times here.

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Florida Covering Kids & Families (FL-CKF), a community and consumer-focused nonprofit initiative based at the USF College of Public Health, has received a record-breaking $11.9 million from the U.S. Health and Human Service (HHS) Centers for Medicare and Medicaid Services. 

The grant will be used for the ninth year of the Affordable Care Act (ACA) Health Insurance Marketplace enrollment and outreach programs. 

According to its website, “FL-CKF works collaboratively with Florida agencies and stakeholders to advocate and conduct outreach to ensure all Floridians have access to affordable health care coverage. The initiative aims to foster and facilitate innovative methods for enrolling and retaining eligible children in Florida’s publicly funded insurance programs (Florida KidCare & Medicaid) and enrolling and retaining eligible adults in the Federal Health Insurance Marketplace.”

Jodi Ray, director of FL-CKF, says the group will receive $11.9 million per year for the next three years, for a total of nearly $36,000,000. 

That’s the highest any state has been awarded (North Carolina came in a distant second this year, with $4.9 million awarded) and a huge increase over last year’s $1.6 million that was awarded under the Trump administration. 

“Previously, we had to scale way back, because we lost resources,” Ray commented. “And now we’re expanding, because we’ve been awarded back those resources and more.”

Ray says she thinks FL-CKF received such a hefty grant award because the federal government looked at the group’s history and knows that it performs. 

“We’ve always exceeded our goals,” Ray said. “In fact, Florida has ranked the highest in enrollments for the marketplace every year. And we have nationally recognized programs. We’ve had at least six different states come to us asking for help with grant writing. And a lot of other grantees come to us looking for technical support. We do a really good job of doing what we are supposed to be doing—getting people enrolled in the ACA.”

Ray says much of the money will go to hire more Navigators (specially trained individuals who help consumers “navigate” the healthcare marketplace) to meet the increasing demand for affordable healthcare. According to Ray, their numbers will grow from about 60 who are staffed during the open enrollment period to 200 across the state who will work year-round. The money will also be spent on outreach and health education programs, including those centered around COVID-19 testing, vaccines and other protections. 

While Ray says she’s thrilled to receive such a significant grant, she also acknowledges that it’s overwhelming.

“I’m not gonna lie—it’s a bit stressful,” Ray said. “I feel very anxious about it because it’s a big undertaking, and we really do need more people and more equipment on board. What’s more, the HHS is going to be doing a lot of intense marketing, so I think that will drive a lot of people to our team.”

This year’s open enrollment period for health coverage extends from Nov. 1 to Jan. 15. “We have a lot of work to do,” Ray said. “But, thankfully, we have a longer enrollment period.” 

Story by Donna Campisano for USF College of Public Health

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U.S. President Joseph Biden has opened a special Affordable Care Act enrollment period to run until May 15, and the USF College of Public Health’s (COPH) Florida Covering Kids & Families (FL-CKF) program is ready to assist.

FL-CKF manages the USF State Navigator Program and seven other organizations (collectively referred to as the “Covering Florida” consortium) that provide Navigator services across Florida.

Jodi Ray, director of FL-CKF, says this special open enrollment period (SEP) is open to everyone using the healthcare.gov platform specifically.

“This SEP is in response to the COVID-19 public health emergency, which has left millions facing health problems, uncertainty and exceptional circumstances,” she said. “Consumers who enroll under this SEP will be able to select a plan with coverage that starts prospectively the first of the month after plan selection.”

She also says consumers will have 30 days after they submit their application to choose a plan.

“This SEP will not involve any new application questions or require consumers to provide any new information not otherwise needed to determine eligibility and enroll in coverage. Nor will they have to provide any information documenting a qualifying event, which is typically required for a special enrollment period,” Ray said.

Ray and her team of navigators are primarily booking virtual and phone appointments; however, they have adjusted their efforts accordingly to meet consumer needs.

“The reality is not everyone can be served that way,” she said. “We live in a state where there is still a digital divide. Lack of access to broadband and varying levels of both computer literacy and health insurance literacy can make reviewing, for example, 105 plans in Hillsborough County, very difficult. This is especially true when you add in language and cultural differences. Our job is to help everyone who needs help and do it in the way that is best for the individual.”

But, preventing the spread of COVID-19 while attending to those needs has also been on the forefront.

“As public health workers, we understand that we have to take the safety of both the consumer and staff seriously. While the COPH has really helped us with setting up our office safely, we are still trying to give as many consumers as possible those remote appointments,” she said.

Anyone who needs assistance in getting health coverage through the marketplace should call Covering Florida at 877-813-9115 or go on the website (coveringflorida.org) and book directly with a navigator closest to their zip code.

Ray said she anticipates longer enrollment periods in the future, given the change in administration in the White House. She also noted that past enrollment periods had gone down to as little as six weeks during the Trump administration. 

Last year, the project enrolled 2,788 consumers, and the two previous years before that 2,708 and 3,879 consumers.

“Of course, before 2017, the resources for enrollment and outreach were significantly higher, and so were our enrollment numbers,” Ray said. “Compared to just normal SEPs, we are running higher in call volume reflective of the open enrollment period for the same amount time.”

This, she says, is due in part to the pandemic.

“A lot of individuals who have mostly relied on employer coverage for access to health insurance are really having a tough time,” she said. “For example, gig workers and those in the performing arts are really needing help to navigate these programs they have never used. Since the number of individuals like this is growing at a pretty fast rate, this SEP will allow those who might have missed the last open enrollment period because they were unaware of the deadlines to apply and see if they can find an affordable plan, even if for the interim.”

She also noted that for those who already selected a plan during the last enrolment, changes can be made during this special enrollment period.

“This is a good chance to make sure that the plan they signed up for during the fall open enrollment period is still the best fit,” she said. “People might have a better idea of what their income and situations will be like for 2021. They may want to see if the plan they selected will meet their needs.”

Story by Anna Mayor, USF College of Public Health

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Colorectal cancer is the second-leading cause of cancer-related deaths in the US. While the Affordable Care Act (ACA) covers colorectal cancer screening (CRCS) procedures that can catch colorectal cancer early, when it’s most treatable, there are disparities in utilization rates. 

Dr. Aldenise Ewing, a USF College of Public Health (COPH) alum, and her colleagues wanted to find out why. Their research, “The Early Impact of the Affordable Care Act Upon Colorectal Screening Utilization in Florida,” was published in the fall issue of the Journal of Health Disparities Research and Practice. The study was conducted with the help of fellow COPHers Drs. Marlene Joannie Bewa, Claudia Parvanta and Dinorah Martinez Tyson, as well as others.

The research was a collaborative effort and conducted as part of a larger study funded through a Centers for Disease Control and Prevention (CDC) grant to the Florida Prevention Research Center (FPRC). The FPRC was previously designated as one of 26 Health Promotion and Disease Prevention Centers in the nation funded by the CDC.

“Recommended screening for adults age 50 and older could prevent more than 50 percent of [colon cancer] deaths, yet rates in Florida vary based on certain demographic factors including race/ethnicity, gender and insurance status,” said Ewing, who is now an applied postdoctoral fellow in the behavioral oncology program at Moffitt Cancer Center. “Knowing that Florida has not expanded Medicaid, and the age for recommended screening has now been lowered to 45 nationwide, it was important for us to enhance our knowledge of remaining barriers by speaking with health care providers.”

The researchers interviewed a total of 22 health care providers about their experience with the ACA and CRCS utilization. The providers noted that some of the individual-level barriers patients faced in utilizing CRCS were a general lack of knowledge of the importance of the screening and fear of the procedures. But the biggest barriers of all, said Ewing, were at the organizational level. These barriers included unaffordable health care and out-of-pocket costs (such as lab fees) associated with the screening methods, even with ACA coverage.

“Our country has decidedly linked health care to employment,” Ewing said. “Yet for many working adults, doctor visits for routine cancer screenings are still not affordable. With regard to colorectal cancer specifically, even effective at-home based alternatives to a colonoscopy—still the gold standard—require organized clinic partnerships for laboratory testing and follow-up diagnostic colonoscopies as needed. Federally Qualified Healthcare Centers (FQHCs) provide these services on a sliding fee scale, but they are less widely available and critically dependent on federal funding to sustain partnerships.”

What will it take to get cancer screening utilization rates up?

“This is a deeply rooted systemic issue with many barriers requiring many solutions,” Ewing said. “But we must continue to publish studies that highlight the inequities in cancer disparities and push for equitable health policy at the state and federal levels.” Building authentic research partnerships to meet the needs of the underserved is also a step in the right direction, she noted.

Bewa, a COPH PhD student, FPRC research assistant and one of the study’s co-investigators, concurs.

“It’s important to ensure that communities are educated and aware of their cancer risk as well as the screening options and resources available to them that address barriers,” said Bewa. “Overall, a health equity lens is needed to address colorectal cancer screening barriers and disparities. We hope [our study results] will be used by policymakers to address the cancer burden in Florida.”

Story by Donna Campisano, USF College of Public Health

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On January 13, Jodi Ray, director of Florida Covering Kids and Families (FL-CKF) , and members of her team visited the White House for a formal award ceremony honoring 50 of the campuses who took part in the White House Healthy Campus Challenge.

The USF College of Public Health’s FL-CKF program is the largest Navigator program in the nation, with USF receiving a total of $21 million over the past four years to operate the program.

Navigators provide outreach and enrollment services to anyone looking to enroll for health care coverage in the Federal Health Insurance Marketplace.

Ray enrolled USF in the challenge, a national effort to focus more engagement toward students and young people on getting enrolled in health coverage, at the beginning of this year’s open enrollment period.

According to Ray, the White House was hoping that at least 40 campuses would sign-up for the challenge, however a total of 350 other campuses across the nation took part in the effort.

(From left) FL-CKF program manager Dr. Avery Rosnick-Slyker, navigator project coordinator Xonjenese Jacobs, White House deputy chief of staff Kristie Canegallo, and FL-CKF program director Jodi Ray receive an honorary award for participation in the White House Healthy Campus Challenge. (Photo courtesy of Jodi Ray)

Ray and her team of USF Navigators held various health care enrollment events on the USF campus, known as “Nav-Labs,” where the campus and community were free to speak with Navigators for enrollment assistance on the spot.

She said they also expanded their reach through strategic social media campaigns and messaging.

“The White House told me they designed the initiative [challenge] after our project,” Ray said. “I had no idea they were watching us this closely.”

Ray said she submitted a comprehensive summary of activities her team took part in to reach students, including details of enrollment engagement efforts at Hillsborough Community College, Eastern Florida State College, Miami-Dade College, and others across the state.

“We decided to capture not just what we were doing within the USF community, but how the USF grant was doing this with other campuses around the state,” she said. “We were so broad in terms of our campus challenge outreach. We wanted everyone engaged with this effort, so while we do a lot with the USF campus, we talked about all of the work we’ve been doing.”

The White House officially recognized a select group of the campuses that took part in the challenge with a certificate of honor.

While there, Ray was also asked to speak on a panel, which was live streamed via the web, to discuss millennial enrollment trends, a group that Ray said is typically the slowest to enroll in health care coverage.

Director of FL-CKF, Jodi Ray (far right), speaks on White House panel discussing millennial enrollment trends and how she and her team have team helped students get enrolled into health care coverage on college campuses. (Photo courtesy of USF COPH)

Former first lady, Michelle Obama, also met with the group for a photograph and an informal meet and greet with attendees.

Ray said that while there are talks of repealing the Affordable Care Act, she is proud to know that it has helped millions obtain coverage.

“I hope they [Congress] can get beyond the philosophical and political and work to make it even better,” Ray said. “We know 20 million have enrolled in health insurance that didn’t have it.”

Former First Lady Michelle Obama joins representative from Healthy Campus Challenge winning schools for a group photo during the Affordable Care Act (ACA) Healthy Campus Challenger Winner Day in the East Room of the White House, Jan 13, 2017. (Official White House Photo by Lawrence Jackson) This photograph is provided by THE WHITE HOUSE as a courtesy and may be printed by the subject(s) in the photograph for personal use only. The photograph may not be manipulated in any way and may not otherwise be reproduced, disseminated or broadcast, without the written permission of the White House Photo Office. This photograph may not be used in any commercial or political materials, advertisements, emails, products, promotions that in any way suggests approval or endorsement of the President, the First Family, or the White House.

Open enrollment ended on January 31, however, the special enrollment period is now open. For more information about obtaining coverage in 2017, visit healthcare.gov or call a USF Navigator at 813-803-0628.

Story by Anna Mayor, USF College of Public Health

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The Florida Covering Kids & Families (FL-CKF) Program at the USF College of Public Health’s Lawton and Rhea Chiles Center, was awarded Navigator program funding totaling $5,813,294.

The award, funded by the Department of Health and Human Services Centers for Medicare and Medicaid Services, was presented on September 2.

The USF Navigator program, operated in the COPH, is the largest awardee in the United States. USF has received a total of $21 million over the past four years to operate the program.

This is the second year of a three-year funding cycle for returning grantees that currently provide in-person assistance to help consumers navigate, shop, and enroll in the wide variety of federally-facilitated Health Insurance Marketplace coverage options.

USF Navigator Michelle Ray assists a student consumer with enrollment options during the 2015 Nav-Lab at the USF Marshall Center. (Photo courtesy of FL-CKF)

“I’m really proud of the fact that we will be able to continue to support the infrastructure that we built. We know, because we’ve collected enough data, that it’s been really effective in helping consumers get access to health care coverage,” said Jodi Ray, program director. “We’ve had the largest impact in Florida, a state that had the largest uninsured rates.”

The USF Navigators, along with 11 Covering Florida consortium partners, cover the entire state of Florida, providing outreach and enrollment services to cover all 67 Florida counties.

The Covering Florida consortium consists of: Broward Regional Health Planning Council, Health Council of Southeast Florida, 90Works, Florida CHAIN, Health Planning Council of Northeast Florida, Primary Care Access Network, Health Planning Council of Southwest Florida, The Family Healthcare Foundation, Health Council of South Florida, Suwannee River Area Health Education Center, and United Way of Brevard County.

According to Ray, FL-CKF and its consortium of partners focus on advocating for and increasing access to care and services via enrollment and education services for individuals with limited English proficiency, disabilities, the LGBTQ community, college students, populations underserved in the current private health insurance market, and vulnerable populations.

Florida Covering Kids & Families director Jodi Ray (right) poses with U.S. Representative Kathy Castor (left) and U.S. Secretary of Health and Human Services Sylvia Burwell (center) before a press conference marking the beginning of open enrollment year two for the Health Insurance Marketplace. (Photo courtesy of USF Health)

Multilingual Navigators also attend outreach events, produce brochures in multiple languages, conduct workshops and give interviews in various languages.

“We’re talking about 100s of thousands of people that we’ve been able to help get access to health coverage and health care and also the millions that we’ve been able to inform around the state each year as a result of these grants as well,” Ray said.

Florida leads enrollment in the Marketplace for three consecutive years, according to Ray, with the state enrolling 1.7 million in 2016 and more than 90 percent receiving financial assistance to lower their premiums and out-of-pocket costs.

Ray was invited to attend an Affordable Care Act speech by President Obama held in Miami last month, where she got to speak directly with him regarding Navigator work over the years.

President Barack Obama participates in a photo line prior to an Affordable Care Act (ACA) health care event at Miami Dade College in Miami, Florida, Oct. 20, 2016. (Official White House Photo by Pete Souza). (This photograph is provided by THE WHITE HOUSE as a courtesy and may be printed by the subject(s) in the photograph for personal use only. The photograph may not be manipulated in any way and may not otherwise be reproduced, disseminated or broadcast, without the written permission of the White House Photo Office. This photograph may not be used in any commercial or political materials, advertisements, emails, products, promotions that in any way suggests approval or endorsement of the President, the First Family, or the White House.)

“I spent a good part of that conversation with him thanking me and me thanking him, and then me hugging him and then us thanking each other again,” she said. “He told me how proud he is of the work that they’ve [Navigators] have done, so it was really awesome to have the president of the United States tell you how proud he was.”

Open enrollment began on Nov. 1 and will continue through Jan. 31. Ray said plans must be chosen by Dec. 15 in order to take effect by Jan. 1.

Navigators from across the state of Florida come together once a year at USF to debrief on the year’s enrollment efforts, including best practices, lessons learned and goals moving forward. (Photo by Lindsay Kuznia)

“For people who have insurance, it’s important for them to look at what the new plan options are and to see that the plan they are enrolled in is still right for them,” Ray said. “Penalties also keep going up and it becomes more unaffordable not to have health insurance. If you’re planning on just paying the penalty, you have to keep in mind all of the out-of-pocket costs for any health services that you may need to have as well.”

The penalty for not having health care coverage will be $695 or 2.5 percent of your total household income, whichever is higher, according to Ray.

The complete list of Navigator awardees and information about Navigators and other Marketplace resources is published online.

Ray said to schedule an appointment with a Navigator anywhere in the state, visit coveringflorida.org. You may also reach a USF Navigator directly by calling (813) 803-0628.

Story by Lindsay Kuznia, USF College of Public Health, and Anna Mayor, USF College of Public Health

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#GETCOVERED! USF!

Getting health care coverage is about taking personal responsibility for one’s health and financial well-being.  It’s about being an independent adult and protecting oneself. It is important to remember these critical dates:

• December 15: Last day to enroll in or change plans for new coverage to start January 1
• January 1: 2016 coverage starts for those who enroll or change plans by December 15
• January 15: Last day to enroll in or change plans for new coverage to start February 1
• January 31: 2016 open enrollment ends. Enrollments or changes between January 16 and January 31 take effect March 1

To schedule an appointment for any of the events or an individual meeting with a Navigator, call 813-803-0628 or visit http://www.enrollamerica.org/connector/

If attending Nav-Lab or visiting a Navigator for an individual appointment, please bring the following information:

• Social Security Numbers or document numbers for legal immigrants (including Certificate of Naturalization and/or Certificate of Citizenship)
• Employer and income information for every member of your household who needs coverage (i.e.: pay stubs and/or W2 forms)
• Policy numbers for any current health insurance plans covering members of the household
• Information about job based coverage for all members of the household

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As the third-year of open enrollment kicked off  nationwide Nov. 1 for the federal Health Insurance Marketplace, attention was once again on the USF College of Public Health, which for the second consecutive year attracted the largest Navigator grant in the country.  This time Tampa Mayor Bob Buckhorn and White House Special Assistant to the President Michael Smith toured the community outreach event hosted by USF Health navigators, observing firsthand students and families signing up for health care insurance.

The “Nav-Lab” was set up in the USF Marshall Student Center and both Buckhorn and Smith were introduced to navigators and consumers by Jodi Ray, project director for the Florida Covering Kids & Families (FL-CKF) program at the Chiles Center for Healthy Mothers and Babies, USF College of Public Health.

The added attention stems from the fact that USF received a $5.9M 2016 Navigator grant, once again the country’s largest award, to help educate uninsured Floridians about the insurance plans that can best meet their health care and financial needs and assist those eligible with enrollment.  This year, the focus will be to help consumers understand how to get the most out of their coverage as well continue new enrollments and renewals, officials said.

After visiting the consumer Nav-Lab, Buckhorn and Smith joined other representatives from USF, Enroll America and a USF Health Morsani College of Medicine student, who is a local Marketplace consumer, for a press conference to talk about this year’s enrollment.

(from left) Michael Smith, Jodi Ray and Tampa Mayor Bob Buckhorn at ACA Open Enrollment Kickoff in the USF Marshall Ctr.

Open Enrollment gives millions of uninsured Floridians the opportunity to enroll in health coverage for the calendar year of 2016. According to the U.S. Department of Health and Human Services (HHS), almost half of the remaining Marketplaces-eligible uninsured are between the ages of 18 and 34. Also, despite historic gains in coverage, Latinos and African Americans are still more likely to be uninsured than their white counterparts.

Because of these facts, this year’s push is keenly focused on that younger group and on minorities, Smith said.

“You could not talk about health care in this country without talking about serving what are some of our most vulnerable youth and communities,” Smith said.

Read the full story at USF Health News

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